Youth Support
Young Refugees and Asylum Seekers

 

Health and Development Questionnaire   -  Male 

Thank you for completing this questionnaire which will be very important in increasing our knowledge of health of different cultural groups.

The information will be kept entirely confidential and will be treated anonymously.  However we do need some of your personal details in case we need to contact you to clarify any item and to make sure that all the questionnaires are genuine. We would also like to inform you of the results of the research.

Please complete as many questions as you can :-– please feel free to put approximate answers if you do not know exactly the details   any information is of help.

If you have any queries you can email us  You will also find explanations of the questions and development charts on the website. If you prefer to print off and complete a hard copy you can download a word document here.

Contact Information
Name
Address
Telephone
E-mail

Background :-

Which Country does your family originate from?

If other please state 

Racial / Ethnic origin:-

(Are you from a particular ethnic or tribal group?  For example Kurdish; Tajik; Hamar)

 Racial /Ethnic origin: 

Language:- 

 What is your ‘mother tongue’  or first language?

Do you speak any other languages?

(please list) 

 Age :-

If you are in UK now -

How long have you been in UK? 

 

Education:-

Where were you educated?

 

What level of education  did you reach?   Primary / secondary / University / Vocational (trade)    

What is your occupation / profession? 

Family Background:-

Parents   

Father

Mother

Are your parents still alive?

 

If so are they in good health?

 

 

How old are they?

 

 

If parents have died – how old were they when they died?

 

 

What did they die of?

 

 

Roughly how tall were they?

 

 

How many brothers and sisters do you have?

  

Where did you come in the family? (eg youngest, oldest, second )

 

Does anyone in the family suffer from any serious or hereditary illness?

  

When you were a child growing up did you ever go hungry or not have enough to eat?

 

Are you married?                          

 If so at what age did you marry?  

Do you have children?

 If so how old were you when your first child was born?    

[If you have children or young relatives it would be extremely helpful if you could fill in a health questionnaire for them too and if at all possible allow them to be involved in our age assessment study] 

Early History

Do you know if your birth was a normal birth?

Any problems you are aware of?  (eg premature, caesarean etc) 

Birth weight                             

Were your parents ever worried about your health or development?

 

If so in what way?

Did your mother ever say you were ahead or behind the other children?

 

Did the teachers at school ever say you were slower or brighter than the other children?

Were you one of the tallest in your class at school or amongst your group of friends?

(At what age?)

Growth

What is you present  Height?

 

What is your  Weight?              

 Please measure your waist:-

What shoe size are you?

(if you do not know please measure your bare foot length with a ruler)

 

When do you think you stopped growing?  (reached your adult height)

Do you remember a time in your teens when you suddenly grew taller?

 

How old do you think you may have been when that happened?

 

If you know your height or weight at any time before the age of 20 please let us know what these measurements were and your age at the time:-

 

Skin

Did you have a lot of spots – ‘Acne’  when you were growing up?

Do you remember how old you were when you had spots ?

Were they on your face or back or both?

Teeth

Were your teeth healthy when you were growing up?  

Did you have any teeth out before the age of 20? 

Young teenagers usually have seven teeth in each of the four quarters of the mouth – seven upper left / seven upper right/ seven lower left / seven lower right making 28 in total. The last teeth, called third molars or WISDOM teeth grow at the back so that most adults then have 8 teeth in each quarter of the mouth – making 32 in total.

Do you have your back ‘Wisdom’ teeth?

When did you get the first one?                                           

When did you get the last one?         

General Physical

Would you describe yourself as muscular?

Would you describe yourself as a ‘heavily built’ ; 'medium built' or ‘lightly built’  person?

Please measure around the middle part of your upper arms:-  

Right:                       Left:

When do you think you developed your adult build?

Were you muscular as a teenager?     If so from what age?

What shirt collar size do you have?  

Since when have you been this size?

Body hair – pattern

Do you have much body hair ?

At what age did you get hair on your body?  

Your chest?

Axilla / Armpits  When did you get adult hair under your armpits?

Facial - When did you first notice hair on your upper lip - in the moustache area?

When did you first notice hair on your chin?                           

When did you get hair on your upper neck?

When did you get hair on your lower neck?

Some boys start to shave before they have full beards  - when did you first shave? 

Have you ever shaved to make your beard grow more?

The pubic hair begins to grow in young teenagers - at first it is just around the base of the penis and then spreads out and up.  You may not remember the stages (below)– if you can estimate then please do so – otherwise try to remember when you think you first noticed that you had pubic hair?

If you shave your pubic hair – when did you first start to shave it?

When did you first get hair at the base of the penis?  (stage 3)

When did the hair spread across in a triangle shape? (stage 4)

When did your pubic hair spread sideways onto your thighs? (stage 5)

When did it spread up along the middle of your lower abdomen? (stage 6)

Voice – Do you remember when your voice dropped or broke?

Sexual organs –

Did you have any health problem with sexual development or herniae?

Do you remember how old you were when you could say you were fully sexually developed? (ie of adult proportions)

Thank you very much for completing this questionnaire

Comments :-

Please make any additional comment you wish with regard to your development or growth. Or add any information or any message you would like to send.

Youth Support Services
Telephone: 020 8659 9926
Fax: 020 8659 3309

Services@YouthSupport.net